Q. Where do the 9th District candidates stand on health care? A. Not on the same side.
Republican
The election, which includes two third-party candidates, is
The race comes as the
The two main
The Affordable Care Act
Bishop has called the ACA a "disaster that needs to be repealed and replaced." He believes the 20 million people now covered by the law could find affordable coverage in a new competitive market.
For him, that market would include popular parts of the ACA such as coverage for pre-existing conditions and the ability for young adults to stay on their parents' policies through age 26. Those, he said, could still be required by government.
"What we need is robust, wide-open competition," he told the Observer. "But there will always be a role for regulation of insurance coverage. . . . There is uniform support on both sides for policies to require coverage of pre-existing conditions (and young adults)."
McCready likes the ACA but would "fix" it. He says that would include making subsidies more available and enticing young people into the system by offering catastrophic plans. He would shift pricing from a fee-for-service model to a "value-based" one where patients are charged not by procedure but by outcome.
Striking down the ACA, he believes, would mean an end to affordable coverage for people with pre-existing conditions.
Health care costs
Bishop said unfettered competition could bring down costs.
"America's story is how market economics make thing affordable, from the Model T to the modern-day smartphone," he said, adding that health care services.
He said government could help by demanding price transparency from drug makers, giving consumers choices through a health savings account and ending laws like the one that requires N.C. hospitals to get state approval before adding new facilities. (He introduced a bill that would end that so-called Certificate of Need requirement.)
McCready says he would reduce costs by bringing more people into the ACA by adding plans like catastrophic coverage, lowering prescription drug costs, bringing more and expanding Medicaid in
Medicaid expansion
Since adoption of the ACA,
"It is a no-brainer," McCready says. "It's economically the right thing to do. It's morally the right thing to do."
Critics like the
Bishop calls expansion "a pig in a poke."
"The answer is bring in . . . competition," he said. "The wrong answer is bringing in more government to destroy the market even more."
Bishop said he's reserving judgment about a
"Medicare for all"
Several Democratic presidential candidates and lawmakers are calling for "Medicare for all," with proposals ranging from a single-payer health system to a public option. Neither
"I'm interested in things we can actually get done working with both sides of the aisle," McCready says. "And many of these plans are unrealistic."
Bishop sees it as a wholesale government takeover.
"If Obamacare has been a disaster, that would be a thermonuclear disaster," he said.
Prescription costs
Last month McCready went to a
He also would allow Medicare to negotiate prices with pharmaceutical companies, something it's now prohibited from doing. According to the
Bishop opposes allowing Medicare to negotiate drug prices. Instead he'd consider steps such as indexing
"Striking the right balance between intellectual property and patents is worth reviewing," he says.
McCready has attacked a pair of Bishop's health care votes.
In 2017 Bishop was the only senator to vote against the final version of a bill called the Pharmacy Patient Fair Practices Act. Now law, it allows pharmacists to talk to patients about lower-cost alternative drugs. However, he had voted for an earlier
In 2015, Bishop, then in the House, was one of just 10 members to vote against the Cancer Treatment Fairness Act, which would have required health plans to charge cancer patients no more for oral chemotherapy than for standard intravenous treatment. Bishop has called it "a pro-big pharma bill" that would "increase the cost of insurance by adding mandates for expensive new drugs . . . rather than allowing proven and effective older drugs to be used first."
Opioids
More than 13,000 North Carolinians have died of opioid overdoses in the last two decades, according to state officials.
This week Cooper signed a bill similar to one Bishop sponsored that would increase penalties on people who distribute controlled substances when that distribution results in death. He's open to government regulation if needed.
"I don't think there's a single magic bullet that will fix it," he said of the problem.
McCready says while it takes a multi-pronged approach of prevention and treatment options, Medicaid expansion would bring needed services to more people.
Rural hospitals
Six rural hospitals in
In April the CEOs of seven rural N.C. hospitals told the governor they could close if Medicaid is not expanded. To McCready, the answer to the health of rural hospitals "is as simple as Medicaid expansion."
But critics such as the
"How do you improve the lot of rural hospitals by making them lose money on more patients?" Bishop says.
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